Based on the view that wind pathogen runs through the entire course of the occurrence and development of nephrotic syndrome， it is proposed that the core pathogenesis of refractory nephrotic syndrome （RNS） in children involves imbalance of the lung， spleen， and kidney， invasion of wind pathogen， and stagnation of turbidity and stasis， and that directing the turbid downward with wind medicinals is the key therapeutic strategy. In clinical practice， according to the distinct pathogenic characteristics of three patterns， including defensive qi insecurity of the lung， yang deficiency with loss of regulation， and binding of turbidity and stasis， three corresponding methods are applied， which are diffusing the lung to consolidate defensive qi， elevating yang to supplement the spleen and kidney， and activating blood to unblock turbidity and stasis. For the pattern of defensive qi insecurity of the lung， wind medicinals are used to penetrate and disperse external pathogens， such as fangfeng （Radix Saposhnikoviae） and mahuang （Herba Ephedrae） for diffusing the lung， dispersing wind， and consolidating defensive qi. For yang deficiency with loss of regulation pattern， wind medicinals are employed to elevate yang and assist transformation， such as shengma （Rhizoma Cimicifugae） and gegen （Radix Puerariae Lobatae） for raising clear yang， warming and activating the spleen and kidney. For binding of turbidity and stasis pattern， wind medicinals with scurrying and collateral‑unblocking properties are used， such as jixueteng （Caulis Spatholobi）， luoshiteng （Caulis Trachelospermi）， and chuanshanlong （Rhizoma Dioscoreae Nipponicae） for dispelling wind， activating blood， resolving stasis， and directing turbidity downward. In all these methods， the core principle is to use wind medicinals to regulate qi movement， open and unblock the sweat pores， and separately eliminate turbid pathogens， thereby providing a theoretical and practical basis for the traditional Chinese medicine diagnosis and treatment of RNS in children.

Based on the view that wind pathogen runs through the entire course of the occurrence and development of nephrotic syndrome， it is proposed that the core pathogenesis of refractory nephrotic syndrome （RNS） in children involves imbalance of the lung， spleen， and kidney， invasion of wind pathogen， and stagnation of turbidity and stasis， and that directing the turbid downward with wind medicinals is the key therapeutic strategy. In clinical practice， according to the distinct pathogenic characteristics of three patterns， including defensive qi insecurity of the lung， yang deficiency with loss of regulation， and binding of turbidity and stasis， three corresponding methods are applied， which are diffusing the lung to consolidate defensive qi， elevating yang to supplement the spleen and kidney， and activating blood to unblock turbidity and stasis. For the pattern of defensive qi insecurity of the lung， wind medicinals are used to penetrate and disperse external pathogens， such as fangfeng （Radix Saposhnikoviae） and mahuang （Herba Ephedrae） for diffusing the lung， dispersing wind， and consolidating defensive qi. For yang deficiency with loss of regulation pattern， wind medicinals are employed to elevate yang and assist transformation， such as shengma （Rhizoma Cimicifugae） and gegen （Radix Puerariae Lobatae） for raising clear yang， warming and activating the spleen and kidney. For binding of turbidity and stasis pattern， wind medicinals with scurrying and collateral‑unblocking properties are used， such as jixueteng （Caulis Spatholobi）， luoshiteng （Caulis Trachelospermi）， and chuanshanlong （Rhizoma Dioscoreae Nipponicae） for dispelling wind， activating blood， resolving stasis， and directing turbidity downward. In all these methods， the core principle is to use wind medicinals to regulate qi movement， open and unblock the sweat pores， and separately eliminate turbid pathogens， thereby providing a theoretical and practical basis for the traditional Chinese medicine diagnosis and treatment of RNS in children.

One of the most common adverse reactions associated with cancer and its treatment is sarcopenia,a syndrome primarily caused by the disruption of muscle homeostasis,leading to excessive muscle atrophy and decreased muscle strength.For cancer patients,sarcopenia reflects not only a state of muscle mass loss but also serves as an important factor affecting treatment efficacy and survival rates.However,cancer-related sarcopenia often has a more insidious onset,is not visible to the naked eye,and is easily overlooked.Therefore,it is necessary to recognize the dangers of sarcopenia throughout the cancer treatment process and to identify low muscle mass early.In recent years,as healthcare professionals have increasingly focused on sarcopenia,research on cancer-related sarcopenia has gradually deepened,with new advancements in its assessment,diagnosis,intervention,and impact on anti-cancer treatment.This article provides a review of these key areas to offer a theoretical basis for the clinical practice of cancer-related sarcopenia.

Forensic medicine has been designated as a first-level discipline,presenting new opportunities and challenges for the development of forensic medicine.Since the 1980s,the establishment of foren-sic medicine discipline and the cultivation of high-level forensic talents have become hot topics in the development of forensic medicine in China.Since the 13th Five-Year Plan,the forensic team of Shanxi Medical University has been aiming at the forefront,proposing the development goals of"Five First-class"and the discipline development path"Six Major Achievements".It has selected benchmark disci-plines,identified gaps in disciplinary development,unified thoughts,formulated completion timelines,concentrated superior resources,assigned tasks to individuals,and created an"Organized Fill-in-the-Blank Format"forensic medicine discipline construction model with the characteristics of the new era.The construction model of forensic medicine has achieved good results in the goals,discipline frame-work,scientific research,talent cultivation,discipline team and platform construction,forming a rela-tively complete discipline construction and management system,and accumulating valuable experience for the construction of first-level discipline and high-level talent cultivation of forensic medicine.

Objective To evaluate the performance and clinical application value of EasyNAT nucleic acid test kits for influenza A virus(Flu A),influenza B virus(Flu B),and Mycoplasma pneumoniae(MP)based on cross-primed amplification(CPA)technology.Methods In compliance with relevant standards,the detection limits,cross-reactivity,and anti-interference abilities of the EasyNAT Flu and MP nucleic acid test kits were validated using influenza(Flu)and MP reference materials.Additionally,a total of 811 suspected Flu or MP infection patients who visited the hospital from January 1 to July 5,2024 were enrolled in this study.Their oropharyngeal swabs were collected and tested using reverse transcription quantitative polymerase chain reac-tion(RT-qPCR)as the gold standard to evaluate the concordance and compliance of the EasyNAT Flu and MP nucleic acid test kits,thus assessing their clinical application value.Results The EasyNAT Flu and MP nucleic acid test kits yielded positive results in 8 repeated tests at the detection limit concentrations of the ref-erence materials.No pathogen-specific peaks were detected in Flu and MP negative samples that had been spiked with common cross-reacting pathogens.Furthermore,the detection results of Flu or MP positive sam-ples were unaffected by the presence of interfering substances.Among the 811 clinical samples,the sensitivity of the EasyNAT Flu A test was 97.33%,and the sensitivity for Flu B was 98.47%,both with a specificity of 98.04%.The EasyNAT MP nucleic acid test showed a sensitivity of 97.95%and specificity of 99.03%.The results demonstrated a high degree of agreement with RT-qPCR(Kappa values were over 0.900).Further-more,detection rates of the EasyNAT Flu test kits showed no difference in positive samples with different Ct values(Flu A:χ2=4.20,P=0.08;Flu B:χ2=2.22,P=0.31)and MP test kits showed significant differences in positive samples with different cycle threshold values(χ2=11.84,P<0.01).Conclusion The EasyNAT Flu and MP nucleic acid test kits exhibit excellent detection performance with high sensitivity and specificity.Moreover,the products are easy to operate,offer rapid detection,and provide accurate results.These features make them suitable for primary healthcare settings,with significant potential for clinical application.

Objective:To study the effects of TCM ointment rubbing technique on pain, swelling, and knee joint function in patients with knee osteoarthritis (KOA) after total knee arthroplasty (TKA).Methods:A randomized controlled trial was conducted. In this study, 80 patients with KOA who underwent TKA treatment in the Department of Sports Medicine I, Wangjing Hospital, China Academy of Traditional Chinese Medicine from October 2022 to March 2024 were taken as the study subjects. They were divided into two groups with random number table method, with 40 cases in each group. Both groups were treated with conventional Western medicine + rehabilitation training after surgery, and the observation group was combined with TCM paste mo technique on this basis. VAS score was used to assess the degree of pain at different time points, and skin fold was used to measure the circumference of the upper knee circumference and the circumference of the lower knee circumference, and knee Injury and osteoarthritis outcome score (KOOS) was used to assess the degree of knee joint function recovery.Results:After treatment, the observation group after surgerythe at 7 d (2.57 ± 0.84 vs. 4.00 ± 0.85, t=7.54) and 14 d (0.80 ± 0.93 vs. 2.70 ± 1.04, t=8.56) VAS scores were lower than those in the control group ( P<0.001). After treatment, the observation group after surgerythe at 7 d the superior circumference [(48.32 ± 4.57) cm vs. (50.53 ± 3.97) cm, t=2.32], and inferior circumference [(36.71 ± 2.95) cm vs. (39.21 ± 6.86) cm, t=2.12], at 14 d the superior circumference [(45.68 ± 4.69) cm vs. (47.96 ± 3.89) cm, t=2.37], and inferior circumference [(34.96 ± 2.96) cm vs. (36.70 ± 4.35) cm, t=2.10] were lower than those in the control group ( P<0.05). The observation group after surgerythe at 14 d the the knee joint mobility [(115.32 ± 2.12) ° vs. (113.34 ± 2.16) °, t=4.14] and KOOS scores (85.52 ± 0.82 vs. 80.32 ± 1.13, t=23.56) were higher than those in the control group ( P<0.01). Conclusion:TCM ointment rubbing technique has significant advantages in improving pain, swelling and knee joint mobility after artificial knee arthroplasty, which can effectively restore knee joint function.

OBJECTIVE: This study reports the first imported case of Lassa fever (LF) in China. Laboratory detection and molecular epidemiological analysis of the Lassa virus (LASV) from this case offer valuable insights for the prevention and control of LF. METHODS: Samples of cerebrospinal fluid (CSF), blood, urine, saliva, and environmental materials were collected from the patient and their close contacts for LASV nucleotide detection. Whole-genome sequencing was performed on positive samples to analyze the genetic characteristics of the virus. RESULTS: LASV was detected in the patient's CSF, blood, and urine, while all samples from close contacts and the environment tested negative. The virus belongs to the lineage IV strain and shares the highest homology with strains from Sierra Leone. The variability in the glycoprotein complex (GPC) among different strains ranged from 3.9% to 15.1%, higher than previously reported for the seven known lineages. Amino acid mutation analysis revealed multiple mutations within the GPC immunogenic epitopes, increasing strain diversity and potentially impacting immune response. CONCLUSION The case was confirmed through nucleotide detection, with no evidence of secondary transmission or viral spread. The LASV strain identified belongs to lineage IV, with broader GPC variability than previously reported. Mutations in the immune-related sites of GPC may affect immune responses, necessitating heightened vigilance regarding the virus.
Humans ; China/epidemiology* ; Genome, Viral ; Lassa Fever/virology* ; Lassa virus/classification* ; Molecular Epidemiology ; Phylogeny

OBJECTIVES: To study the clinical characteristics of pediatric Behçet syndrome (BS). METHODS: A retrospective review was conducted on the medical records of children hospitalized in the Department of Pediatrics at the Second Hospital of Hebei Medical University between December 2014 and December 2024 who met diagnostic criteria for BS. RESULTS: Among 45 children with BS, 26 (58%) were male. Oral aphthous ulcers were the most common manifestation (43/45, 96%), followed by genital ulcers (23/45, 51%) and gastrointestinal involvement (18/45, 40%). Genital ulcers were more frequent in girls, whereas ocular involvement was more common in boys (P<0.05). The pathergy test was positive in 10 (22%), and HLA-B51 was positive in 13 (29%). Fecal calprotectin (FC) was elevated in 16 (36%); gastrointestinal involvement was more frequent in children with elevated FC than in those with normal FC (P<0.05). According to the respective criteria, 17 (38%) patients met the International Study Group criteria (1990), 33 (73%) met the International Criteria for Behçet Disease (2014), and 13 (29%) met the Pediatric Behçet Disease criteria (2015). CONCLUSIONS Pediatric BS shows marked clinical heterogeneity. HLA-B51 is associated with disease susceptibility.
Humans ; Behcet Syndrome/genetics* ; Male ; Female ; Child ; Retrospective Studies ; Adolescent ; Child, Preschool ; Leukocyte L1 Antigen Complex/analysis* ; HLA-B51 Antigen

OBJECTIVE: To elucidate how spinal manipulative therapy (SMT) exerts its analgesic effects through regulating brain function in lumbar disc herniation (LDH) patients by utilizing resting-state functional magnetic resonance imaging (rs-fMRI). METHODS: From September 2021 to September 2023, we enrolled LDH patients (LDH group, n=31) and age- and sex-matched healthy controls (HCs, n=28). LDH group underwent rs-fMRI at 2 distinct time points (TPs): prior to the initiation of SMT (TP1) and subsequent to the completion of the SMT sessions (TP2). SMT was administered once every other day for 30 min per session, totally 14 treatment sessions over a span of 4 weeks. HCs did not receive SMT treatment and underwent only one fMRI scan. Additionally, participants in LDH group completed clinical questionnaires on pain using the Visual Analog Scale (VAS) and the Japanese Orthopedic Association (JOA) score, whereas HCs did not undergo clinical scale assessments. The effects on the brain were jointly characterized using the amplitude of low-frequency fluctuations (ALFF) and regional homogeneity (ReHo). Correlation analyses were conducted between specific brain regions and clinical scales. RESULTS: Following SMT treatment, pain symptoms in LDH patients were notably alleviated and accompanied by evident activation of effects in the brain. In comparison to TP1, TP2 exhibited the most significant increase in ALFF values for Temporal_Sup_R and the most notable decrease in ALFF values for Paracentral_Lobule_L (voxelwise P<0.005; clusters >30; FDR correction). Additionally, the most substantial enhancement in ReHo values was observed for the Cuneus_R, while the most prominent reduction was noted for the Olfactory_R (voxelwise P<0.005; clusters >30; FDR correction). Moreover, a comparative analysis revealed that, in contrast to HCs, LDH patients at TP1 exhibited the most significant increase in ALFF values for Temporal_Pole_Sup_L and the most notable decrease in ALFF values for Frontal_Mid_L (voxelwise P<0.005; clusters >30; FDR correction). Furthermore, the most significant enhancement in ReHo values was observed for Postcentral_L, while the most prominent reduction was identified for ParaHippocampal_L (voxelwise P<0.005; clusters >30; FDR correction). Notably, correlation analysis with clinical scales revealed a robust positive correlation between the Cuneus_R score and the rate of change in the VAS score (r=0.9333, P<0.0001). CONCLUSIONS Long-term chronic lower back pain in patients with LDH manifests significant activation of the "AUN-DMN-S1-SAN" neural circuitry. The visual network, represented by the Cuneus_R, is highly likely to be a key brain network in which the analgesic efficacy of SMT becomes effective in treating LDH patients. (Trial registration No. NCT06277739).
Humans ; Magnetic Resonance Imaging ; Intervertebral Disc Displacement/diagnostic imaging* ; Male ; Female ; Brain/diagnostic imaging* ; Adult ; Manipulation, Spinal/methods* ; Middle Aged ; Lumbar Vertebrae/physiopathology* ; Pain Management ; Rest ; Case-Control Studies

Objective:To investigate exercise fear condition and its influencing factors in patients with coronary heart dis-ease(CHD)involving in phase Ⅱ cardiac rehabilitation after percutaneous coronary intervention(PCI).Methods:Conven-ience sampling was performed among cardiac rehabilitation patients from a Shanxi grade-A tertiary hospital between Janu-ary 2023 and June 2023.General data questionnaire,Tampa Scale for Kinesiophobia-Short Version for Heart patients(TSK-SV H),the Multidimensional Scale of Perceived Social Support(MSPSS)and the Post Percutaneous Coronary In-tervention Health Literacy Scale(PPCIHLS)were used for assessment.Pearson and Spearman rank correlation analyses were applied to investigate the relationships between social support factors and health literacy factors with patients'fear of exercise;multivariate linear regression models and quantile regression models were used to analyze the influencing factors of fear of exercise.Results:Among the 118 patients,average TSK-SV H score was(33.78±3.79)points;10.2％patients showed significant fear.The correlation analysis showed that PPCIHLS score was negatively correlated with TSK-SV H score(r=-0.423,P＜0.001).Results from multivariate regression analysis indicated that health literacy,cardiac func-tion class and drinking status affected the average score of exercise fear(P＜0.05 all).The quantile regression model pro-vided additional insights,showing that the impact of factors such as living situation,drinking status,cardiac function class and health literacy on exercise fear varied across different quantiles.Notably,cardiac function class had a consistently posi-tive effect on TSK-SV H score at various quantiles.Conclusion:Improving health literacy and tailored rehabilitation plans are vital to reduce exercise fear and improve cardiac rehabilitation effect.